For years, the Perelman School of Medicine at the University of Pennsylvania has been bridging the great physical distance between the Penn campus in Philadelphia and places around the world, largely through Penn’s Center for Global Health. No distance seems greater than the roughly 8,000 miles between Philadelphia and Gaborone, Botswana, the home of the University of Botswana with which Penn regularly collaborates. The number one tactic? Traveling, sending faculty, staff, and students/trainees to collaborate with and learn from experts on the ground while also hosting University of Botswana faculty and trainees, as well as other Botswana health professionals, at Penn. Then 2020 arrived, and with it, COVID-19.
“The work that our trainees and faculty engage in abroad is invaluable to our mission,” said Megan Doherty, MPH, director of Operations and Programming for the Center for Global Health. “When COVID-19 forced everyone to stop traveling and governments shut down borders, we had to develop a way to still provide research opportunities for trainees and continue to maintain the relationships we have worldwide.”
The development phase consisted of conversations with the Center for Global Health’s partners in Africa, Asia, South America, and Europe to understand their research needs.
“In the United States, there’s sometimes a notion that Americans, no matter the situation or their experience, can just participate in a program and automatically improve it,” Doherty said. “While we’re proud of the work our trainees and faculty do abroad and the tremendous value they can add, we know that our representatives have just as much to learn from our peers abroad as they do from us. And aside from education, our goal at the Center for Global Health is also to truly participate in research and clinical work that complements the efforts of experts abroad. That takes careful pairing and strategy.”
Enter Michael Boateng, a MD and MPH student at Penn, class of 2022. He has completed 3 years of the MD program, and this year, is completing the MPH portion of the dual degree. When an opportunity arose to include global-health research in his MPH coursework, he eagerly raised his hand. He was well positioned to do the research after completing a course this summer where he learned GIS (geographic information systems).
“I saw that the Center for Global Health and Dr. Johnson were looking for a MD/MPH student to assist in rehabilitation research in Botswana, work that could be done remotely,” Boateng said.
Michelle Johnson, PhD, an associate professor of Physical Medicine and Rehabilitation and of Bioengineering at Penn and the director of the Penn Rehabilitation Robotics Lab, studies how robotics and other forms of tech can be implemented to improve the rehabilitation of people around the world, whether they’re from rich nations, poorer areas, or somewhere in between. Her work includes developing and using robots to help patients complete activities of daily living — tasks that everyone needs to do daily, like lifting certain objects or moving around. But to reach one next step in her research this year, she needed to understand how accessible proper rehabilitation is to patients in Botswana. How many specialists are there and where? What is their level of knowledge? What kind of equipment do they have at their disposal? How many patients are they seeing regularly, and how far are patients traveling for an appointment with them? What are the main reasons that patients there need rehabilitation services, and what kinds of services are they most in need of? Answering those questions is the job of Boateng and Dr. Johnson’s collaborators in Botswana.
“In order to really understand the needs of patients and make an impact in the areas most in need, we need to answer those questions first before bringing new technology and more training,” Boateng said.
While continuing his MPH studies, Boateng’s day-to-day research work involves coming up with the right questions for those on the ground in Botswana, conversing with medical experts and government agencies by phone and internet, and compiling data that will later be analyzed, using GIS, to reveal how Johnson’s innovative robotics and strategies can make a difference in Botswana.
“Gathering this data is important because it will help address a much-needed knowledge gap, but it also highlights the importance of partnering with local experts in whatever region you’re studying,” Boateng said. “The people and organizations, in the places we are fortunate enough to work in, know the issues they face much better than outsiders, and so those of us who want to be involved need to collaborate with local experts on the ground when developing research projects or designing interventions.”
“The work Michael is doing really illustrates how helpful our trainees can be without actually crossing any borders,” Doherty said. “We and our partners overseas value face-to-face interaction and in-person collaboration. COVID-19 has really made us miss that. But the pandemic has not put a halt to any progress or scientific investigation with our partners. We have made sure of that.”
Along with Boateng’s work, which he plans to have done by the spring of 2021, the Center for Global Health currently oversees over 20 remote research projects for Penn trainees and trainees from Penn’s partners, and the Center is continuing to build more remote opportunities like this. The Center hopes that, even in a post-pandemic world that is hopefully in the near future, research opportunities like Boateng’s can be available for those who are not able to travel abroad for various reasons.
“We hope remote research opportunities allow more trainees to be exposed to global health while, in turn, providing assistance to our faculty here and our partners abroad,” Doherty said. “The pandemic has made many realize what everyone in global health already knew — the world is connected…and we need to appreciate that.”